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Temporal Relationship Among Pain, Fear, and Motor Function After Total Knee Arthroplasty: An Exploratory Study
Masayuki Koga1,2, Shintaro Fujii1, Yuki Nishi3
1Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, Japan.
European Journal of Pain (London, England)
|January 16, 2026
Summary
Post-surgery knee pain and movement issues influence each other. Early interventions targeting pain and movement can improve recovery after total knee arthroplasty (TKA).
Area of Science:
- Orthopedics
- Rehabilitation Science
- Pain Management
Background:
- Pain, fear, and motor function are interconnected, particularly after total knee arthroplasty (TKA).
- Understanding these relationships is crucial for optimizing postoperative recovery.
Purpose of the Study:
- To clarify the causal relationships between pain, fear, and motor function during the acute postoperative period following TKA.
- To examine longitudinal changes from pre- to post-surgery.
Main Methods:
- Prospective observational study of 27 inpatients undergoing TKA.
- Assessed pain (rest, motion), fear of motion, and knee kinematics (velocity, angle, entropy) preoperatively and at 1 and 2 weeks postoperatively.
- Utilized a cross-lagged panel model to analyze causal pathways.
Main Results:
- Reduced knee movement at 1 week postoperatively predicted increased rest pain at 2 weeks.
- Higher rest pain at 1 week predicted greater movement irregularity at 2 weeks.
- Preoperative factors did not significantly fit the models.
Conclusions:
- Pain and motor function exhibit bidirectional predictive relationships in the acute postoperative phase after TKA.
- These interactions may contribute to persistent pain and functional deficits.
- Targeted early interventions addressing pain and movement are needed to prevent prolonged recovery issues.
